Progressive Care Nursing Certification (PCCN) Practice Exam

For a patient with an extensive history of ACS admitted with acute heart failure, what is an essential ethical principle for the nurse to follow?

1. Predominantly respect medical input over patient input

2. Utilize a surrogate decision-maker if needed

3. Support the patient's autonomy in treatment decisions

4. Encourage family input regardless of the patient’s stated wishes

The correct answer is: Support the patient's autonomy in treatment decisions

Supporting a patient's autonomy in treatment decisions is a fundamental ethical principle in nursing practice, especially for patients with a significant medical history such as acute heart failure resulting from acute coronary syndrome (ACS). Autonomy emphasizes the patient's right to make informed choices about their healthcare based on their values, beliefs, and preferences. In situations involving acute heart failure, patients may have strong preferences about their treatment options, particularly given their previous experiences and values. By upholding the patient's autonomy, the nurse not only respects the individual’s right to govern their own life but also fosters a therapeutic alliance that can enhance patient satisfaction and compliance with treatment. While utilizing a surrogate decision-maker may be appropriate in some circumstances, it should not undermine the patient’s ability to communicate their wishes when possible. The emphasis on family input must also consider the patient's stated preferences, rather than overriding them, which aligns with the principle of autonomy. Respect for medical input is important but should not be prioritized over the patient’s autonomy, especially when the patient is capable of participating in their own care decisions.